Overview of New Therapeutic Developments for Acne

Anja Thielitz; Harald Gollnick

Disclosures

April 13, 2009

In This Article

Azelaic Acid

Azelaic acid 20% in a cream formulation has been established as an efficacious and safe topical drug for 15 years. Azelaic acid 15% gel is approved for the treatment of rosacea in the USA, but also has approval for the treatment of acne vulgaris in Europe. It was clinically tested against the two standard drugs, BPO 5% and clindamycin 1%, in two independent, randomized, blinded comparative trials involving 229 patients.[44] The drugs were applied twice daily for 4 months. Azelaic acid 15% gel proved to be as effective as BPO and clindamycin with a median percentage reduction of the inflamed lesion (papules and pustules) of 70 and 71%, compared with a 77% reduction with BPO 5% gel and a 63% reduction with clindamycin, respectively. The azelaic acid gel was well tolerated and side effects (local burning and irritation) were distinctly less than with BPO but more pronounced than with clindamycin. Despite these side effects, the treatment was well accepted by the majority of patients. In addition, a 1-year European observational study conducted by dermatologists in private practice evaluated the safety and efficacy of azelaic acid 15% gel used as monotherapy or in combination with other agents in more than 1200 patients with acne.[45] Both physicians and patients assessed azelaic acid 15% gel to be effective, with 74% of patients being 'very satisfied' at the end of therapy. Azelaic acid 15% gel was considered to be 'well tolerated' or 'very well tolerated' by 95.7% of patients and the majority of patients were more satisfied with azelaic acid than with previous therapies.

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